Last updated on July 1st, 2019 at 01:37 pm
42% of Americans have seen a therapist at some point in their life.
A further 36% are open to it.
That’s great news in terms of people taking ownership of their mental health, but does your insurance cover it?
In this article, we’ll go over the commonly asked question, “Does Blue Cross Blue Shield cover therapy?”
We’ll also go over some of the options available if you or a loved one covered by your Blue Cross Blue Shield insurance needs to receive more intensive care such as inpatient treatment.
Read on to find out more about how you can stay mentally well with your insurance plan.
What Is a Therapist, and How Are They Trained?
Therapy is typically defined by sessions in which you visit a qualified therapist to discuss your issues. Most often, therapists have trained by first studying in psychology in college.
In order to be a trained psychologist in the United States, they will need to have attended a graduate program as well. Many go on to pursue a doctorate in psychology, or even counseling.
Depending on the state, they will likely do an internship or need a certain number of clinical hours in order to qualify as a licensed therapist. Many will practice in graduate schools by counseling undergraduate and graduate students as part of their own studies.
Once they become qualified to practice, they can join a practice or choose to open their own. Some may also choose to work with patients who are inpatients in hospitals. Some may decide they want to work with inpatient and outpatient clients and mix and match their schedules to coincide with these things.
Some will participate in a practice while they earn their doctorate in psychology.
Some therapists decide to choose a specialty. For example, they may decide to work with patients with addiction issues or patients recovering from trauma. They may also limit their practice to certain age ranges. For instance, some may have more of an interest in working with adults, while others may only work with children.
What Is Therapy?
Therapy often conjures up an image of lying on a couch while you tell an old man sitting in a chair your problems. He might scribble down a few notes about you during your session.
However, there are many different types of therapy. Most often when people refer to therapy, they refer to counseling. In this format, you often sit with your therapist and discuss problems you’re dealing with, and the therapist provides you with coping skills.
Each therapist has a different approach. One therapist may choose to focus on your past while another may choose to focus on the present. One therapist may choose to focus on coping skills, while others may choose to focus on your inner dialogue.
Every therapist is unique, and thus, every relationship you have with your therapist will be unique.
Therapy is often one-on-one, with just you and the therapist involved. There is an expectation of client-therapist confidentiality, meaning they cannot “tell” on you for anything you’ve said to them. There are certain caveats, though, in which they must. This includes instances of abuse or disclosing that you have committed a serious crime.
You may also have couples therapy, where you and your romantic partner discuss issues you may have in your relationship. You can work on improving them together or may work toward finding a solution for the both of you.
Another type of therapy is family therapy. This is where your immediate family comes together to discuss the family dynamic. Sometimes, this can be in relation to one family member’s issues or addiction. Sometimes, it is just to improve upon the way the family unit functions.
Family therapy can be done with your parents, siblings, children, or grandparents. It all depends on whom you interact with most on a daily basis, and which relationships affect you the most.
The aim of therapy is always to relieve psychological symptoms and to help you, or the family unit, cope, and function in a healthier manner.
What Is the Difference Between a Psychologist and Psychiatrist?
A therapist is typically a psychologist, though a psychiatrist may act as a therapist in some ways. However, the major difference is that a psychiatrist prescribes medication to help you relieve symptoms. This medication can be for short-term or long-term use.
A psychologist does not provide medication. However, they often work closely with psychiatrists and can refer you to someone in their practice if they feel you might benefit from medication. They can also, with your permission, discuss your case with your psychiatrist to help you find the best medication available.
Does Blue Cross Blue Shield Cover Therapy?
Now that you know what a therapist is and does, we’re at the heart of the question. Does BCBS cover therapy?
The answer is yes but not to an unlimited extent. The therapist you wish to see needs to accept Blue Cross Blue Shield insurance. There may be reasons why the therapist of your preference does not accept BCBS insurance, so if this is the case, speak to your therapist of choice about alternatives.
You can find a list of therapists that accept Blue Cross Blue Shield across the United States and Canada here. If your therapist of choice will not accept BCBS, speak to him or her about possibly working on a sliding scale. Some therapists are willing to work with their clients, especially those they have ongoing relationships with.
Each Blue Cross Blue Shield plan is a little bit different. This means that each will cover a certain amount of therapy, or will have you pay different amounts of co-pay. Some plans, for example, may only cover a limited amount of visits.
BCBS may also only cover therapy it deems “medically necessary.” For example, you may need to have a certain diagnosis code for insurance to actually cover your therapy.
In the case of an addiction, your therapist may fill out your insurance forms giving you the code of an alcoholic. However, at a certain point in your recovery, you will no longer meet the criteria for an alcoholic. Therefore, BCBS may decide that they no longer need to pay for your therapy.
This is a common issue many people run into when seeking treatment, so it is important to be aware of this when starting therapy.
This conundrum can be frustrating, especially because most therapists don’t believe there is a point at which someone is “cured.” Most people, instead, could use a form of therapy and support in their life, so pulling it so quickly due to insurance can cause a lot of frustration.
Does Blue Cross Blue Shield Cover Inpatient Stays for Addiction?
Typically, yes. However, this will depend on which coverage plan you have. For some people, they will get almost their entire stay in a rehab facility covered, while others will get very little.
Patients who use the Bronze plan typically have insurance pay around 60% of the costs of an inpatient stay. While that may seem like a lot, inpatient stays can cost up to $100,000 per month for the most expensive inpatient rehabs. In some cases, in order to participate in the program, you must commit to an entire month or longer.
For some people, this could leave them with a bill of $40,000 or more. This doesn’t count travel or accommodation that they may need to make arrangements for in order to receive the inpatient treatment.
If you have the Platinum plan, this will cover around 90% of your inpatient stay. However, again, this doesn’t make things perfect. This plan means the highest cost per month, something that many people can’t afford. This is why many people, instead, opt for plans with lower per month payments, even if it means higher out-of-pocket costs.
With a Platinum plan, the cost of a rehab stay can also still be out of reach. If you stay in a rehab facility for 30 days to the tune of $100,000, you may still receive a $10,000 bill. For many, this is simply not possible, especially if they have spent much of their money on their habit.
Does Blue Cross Blue Shield Cover Inpatient Eating Disorder Treatment?
Yes, it does. However, the issues you run into are the same as the ones you would for an inpatient addiction treatment. Depending on where you choose to receive treatment, a month’s stay can cost between $30,000 and $100,000. Continuing treatment may also continue to rack up the bills.
However, you can still work with Blue Cross Blue Shield to try and negotiate a price and allow you or your loved one to stay in treatment as long as possible.
Why Are Inpatient Programs So Expensive?
There are many reasons why inpatient programs are so expensive. Mostly, it is because they are comprehensive. Some inpatient programs may also treat dual diagnosis, in which they help individuals not only overcome an eating disorder or addiction but can help those struggling with both. Or, they can help individuals struggling with more than one psychological disorder.
In an inpatient program, your entire day is devoted to helping you overcome your addiction or issues. You will spend the day in therapy, group therapy, or in other classes such as art therapy or light exercise.
During an inpatient program, you may receive medical detox to help wean you off of your drug of choice without causing too much harm to your body or mind. Many people use continuously in order to avoid this aspect of recovery. However, medically assisted recovery is much more comfortable.
You will not only have access to your own therapist, but depending on the facility, you’ll also speak to a nutritionist and other experts. You will help craft a plan that will help you succeed in conquering your addiction.
You will also be monitored around the clock to ensure that you do not participate in dangerous behaviors. You also have resources available if you do feel in danger, and there is always someone to speak to if need be.
Does Blue Cross Blue Shield Cover Ongoing Care?
Once you’re released from the inpatient facility, you may do intensive outpatient programs to help keep you on the path to recovery. These programs can be all day, 5 days a week, but you typically will live at home, or in a home for those recovering nearby. This allows you more freedom while continuing in your recovery.
Blue Cross Blue Shield will often pay for these programs as well, but only up to a certain extent and depending on your specific plan. It is important that you speak with the insurance company directly to find out what they will and will not cover in terms of these types of programs.
I Have Blue Cross Blue Shield, But It Isn’t Enough to Cover All of My Expenses
This is a problem many insurance holders run into. While they may get many of their total costs covered, they don’t get enough to ensure a complete and proper recovery.
Many eating disorder or addiction centers will offer scholarships and other programs that allow people who could not otherwise access their program to get the help they need. This helps relieve a big chunk of the financial burden for many.
Speak to the program you’re interested in entering today to find out if they have any similar ways to help out prospective patients.
I’m Ready to Explore My Options
So, now that you’ve received the answer to the question, “Does Blue Cross Blue Shield cover therapy?”, it’s time to start making some decisions.
First, speak to Blue Cross Blue Shield directly about the program you’re interested in, or the therapist you would like to visit.
If you’re ready to start your journey to recovery today, you can contact us to explore your options with Blue Cross Blue Shield. We’re waiting to help you start a new life.